Paulson Kelly G, Park Song Y, Bhatia Shailender, Hippe Daniel S, Nghiem Paul
Paul G. Allen Research Center, Providence-Swedish Cancer Institute, Seattle, Washington; Elson. S. Floyd College of Medicine, Washington State University, Everett, Washington.
Fred Hutchinson Cancer Center, Seattle, Washington; University of Washington, Seattle, Washington.
J Am Acad Dermatol. 2025 Mar 10. doi: 10.1016/j.jaad.2025.03.006.
Merkel cell carcinoma (MCC) is an aggressive skin cancer with poor survival rates. Immune checkpoint inhibitors (ICIs) were Food and Drug Administration-approved for advanced MCC in 2017, but their real-world survival impact remains unclear.
Evaluate whether ICI introduction in the United States corresponded with improved survival.
This cohort study analyzed Surveillance, Epidemiology, and End Results data for MCC patients diagnosed from 2010 to 2021, grouped by 3-year periods, to calculate 2-year overall and relative survival.
For 453 patients with metastatic MCC, 2-year relative survival improved from 23% (2010-2012) to 37% (2013-2015), 42% (2016-2018), and 54% (2019-2021) (P < .001). Median overall survival also increased from 9 to 16 months among these patients. In 4786 MCC patients overall, 2-year relative survival rose from 73% (2010-2012) to 81% (2019-2021) (P = .004), while overall survival improved from 67% to 72% (P = .012).
Surveillance, Epidemiology, and End Results lacks case-level data to link ICI treatment directly to survival, although ICIs represent the major recent treatment advance for MCC.
The introduction of ICIs aligns with a >2-fold increase in survival for advanced MCC patients at the population level, translating to ∼220 fewer deaths per year in the United States.
默克尔细胞癌（MCC）是一种侵袭性皮肤癌，生存率较低。免疫检查点抑制剂（ICI）于2017年获美国食品药品监督管理局批准用于晚期MCC，但它们在现实世界中的生存影响仍不明确。
评估美国引入ICI是否与生存率提高相关。
这项队列研究分析了2010年至2021年诊断的MCC患者的监测、流行病学和最终结果数据，按3年时间段分组，以计算2年总生存率和相对生存率。
对于453例转移性MCC患者，2年相对生存率从2010 -
2012年的23%提高到2013 - 2015年的37%、2016 - 2018年的42%和2019 - 2021年的54%（P < 0.001）。这些患者的总生存中位数也从9个月增加到16个月。在总共4786例MCC患者中，2年相对生存率从2010 - 2012年的73%升至2019 - 2021年的81%（P = 0.004），而总生存率从67%提高到72%（P = 0.012）。
监测、流行病学和最终结果缺乏病例层面的数据来直接将ICI治疗与生存联系起来，尽管ICI是MCC近期主要的治疗进展。
ICI的引入与晚期MCC患者在人群水平上生存率提高两倍以上相关，在美国每年可减少约220例死亡。
